Leana Wen: What your doctor won’t disclose

譯者: Melody Tang 審譯者: Marssi Draw

They told me that I'm a traitor to my own profession,

人們說我背叛了自己的職業，

that I should be fired,

我應該被炒魷魚，

have my medical license taken away,

我的醫師執照應被吊銷，

that I should go back to my own country.

甚至要我回到我自己的國家去。

My email got hacked.

我的電子信箱被駭。

In a discussion forum for other doctors,

在另一個醫生論壇裡，

someone took credit for "Twitter-bombing" my account.

有人聲稱他「推特轟炸」我的帳號。

Now, I didn't know if this was a good or bad thing,

我不知道那究竟是好還是壞，

but then came the response:

後來卻看到回覆說：

"Too bad it wasn't a real bomb."

「真可惜那不是真的炸彈」。

I never thought that I would do something

我從來沒想到

that would provoke this level of anger among other doctors.

我做的事會激起其他醫生

這種程度的仇恨。

Becoming a doctor was my dream.

成為醫生是我的夢想。

I grew up in China,

我在中國大陸長大，

and my earliest memories are of being rushed to the hospital

我最早的兒時記憶就是被緊急送醫，

because I had such bad asthma that I was there nearly every week.

因為我有很嚴重的氣喘， 幾乎每週都去醫院。

I had this one doctor, Dr. Sam, who always took care of me.

當時一直照顧我的是山姆醫生，

She was about the same age as my mother.

她大概和我的母親一樣大。

She had this wild, curly hair,

披著一頭很亂的捲髮，

and she always wore these bright yellow flowery dresses.

她總是穿著鮮黃印花的洋裝。

She was one of those doctors who,

她這種醫生就是

if you fell and you broke your arm,

如果你摔倒斷了手臂，

she would ask you why you weren't laughing

她會問你為何不笑呢？

because it's your humerus. Get it?

因為那是你的肱骨（英文與幽默同音）。 明白嗎？

See, you'd groan,

你在痛苦呻吟，

but she'd always make you feel better after having seen her.

但她總能讓你見到她之後 覺得舒服一點。

Well, we all have that childhood hero

我們都有兒時崇拜的英雄，

that we want to grow up to be just like, right?

希望長大後成為那樣的人，對吧？

Well, I wanted to be just like Dr. Sam.

我從小就想成為山姆醫生那樣。

When I was eight, my parents and I moved to the U.S.,

八歲時我隨父母搬到美國，

and ours became the typical immigrant narrative.

我們的生活和典型的移民一樣。

My parents cleaned hotel rooms and washed dishes and pumped gas

父母靠打掃飯店房間、 做洗碗工和為人加油賺錢，

so that I could pursue my dream.

讓我可以追求我的夢想。

Well, eventually I learned enough English,

後來我學了夠多的英語，

and my parents were so happy

在我進入醫學院 為治療和服務宣誓那天，

the day that I got into medical school and took my oath of healing and service.

我的父母非常開心。

But then one day, everything changed.

但有一天，一切都改變了。

My mother called me to tell me that she wasn't feeling well,

媽媽打電話告訴我她覺得很不舒服，

咳嗽咳很久都不會好， 而且呼吸困難又疲憊。

she had a cough that wouldn't go away, she was short of breath and tired.

Well, I knew that my mother was someone who never complained about anything.

我知道媽媽是那種 從不抱怨任何事的人。

For her to tell me that something was the matter,

當她告訴我這些身體的不適時，

我就覺得這件事很不妙。

I knew something had to be really wrong.

And it was:

結果也是如此：

We found out that she had stage IV breast cancer,

我們發現她是乳癌第四期，

cancer that by then had spread to her lungs, her bones, and her brain.

那時癌細胞已經擴散到 她的肺、骨頭和腦部。

我媽媽當時還是很勇敢並懷抱希望。

My mother was brave, though, and she had hope.

她經歷了手術和放射治療，

She went through surgery and radiation,

and was on her third round of chemotherapy

然後在做第三階段的化療時，

when she lost her address book.

她找不到她的通訊錄。

She tried to look up her oncologist's phone number on the Internet

她試著在網路上找腫瘤醫生的電話，

and she found it, but she found something else too.

她找到了，但她也找到了其他東西。

On several websites,

在一些網站上，

he was listed as a highly paid speaker to a drug company,

她的醫生被列為 一家製藥公司的高薪發言人，

and in fact often spoke on behalf

而且他其實常代言

of the same chemo regimen that he had prescribed her.

他開給她的化療方案。

She called me in a panic,

她驚慌地打電話給我，

and I didn't know what to believe.

我不知道該相信什麼。

Maybe this was the right chemo regimen for her,

也許這個化療方案對她來說是對的，

but maybe it wasn't.

但也可能不是對的。

It made her scared and it made her doubt.

這讓她感到恐懼和懷疑。

When it comes to medicine,

當涉及到藥物時，

having that trust is a must,

信任是必須的，

and when that trust is gone, then all that's left is fear.

但當信任消失後，剩下的只有恐懼。

There's another side to this fear.

這個恐懼還有另外一面。

As a medical student, I was taking care of this 19-year-old

當我還是醫學院學生的時候，

我照顧一位 19 歲的年輕人，

who was biking back to his dorm

他在騎腳踏車回宿舍時

when he got struck and hit,

被一輛休旅車撞倒，

run over by an SUV.

並輾了過去。

He had seven broken ribs,

他的七根肋骨骨折，

shattered hip bones,

臀骨粉碎，

and he was bleeding inside his belly and inside his brain.

他當時腹部和顱內都在出血。

Now, imagine being his parents

現在，你想像他的父母

從兩千多英里外的西雅圖坐飛機過來，

who flew in from Seattle, 2,000 miles away,

to find their son in a coma.

看到他們的兒子仍然昏迷。

I mean, you'd want to find out what's going on with him, right?

你一定想知道他現在是什麼狀況吧？

They asked to attend our bedside rounds

他們請求參與我們的病房巡視，

where we discussed his condition and his plan,

那時我們會討論 病人的現況和處理方案，

which I thought was a reasonable request,

我認為這是很合理的請求，

and also would give us a chance to show them

並且也給我們機會

展示我們是多麼努力和關心。

how much we were trying and how much we cared.

The head doctor, though, said no.

然而主治醫生卻拒絕了，

He gave all kinds of reasons.

他列出了各種理由，

Maybe they'll get in the nurse's way.

例如他們會妨礙護士工作、

Maybe they'll stop students from asking questions.

或許他們會阻止實習醫師提問。

He even said,

他甚至說：

"What if they see mistakes and sue us?"

「如果他們看到我們出差錯， 起訴我們怎麼辦？」

What I saw behind every excuse was deep fear,

我看到在每個藉口背後 是深深的恐懼，

and what I learned was that to become a doctor,

因此我學到：要成為醫生，

we have to put on our white coats,

我們要穿上白袍，

put up a wall, and hide behind it.

築起一道牆，把自己藏在牆後。

There's a hidden epidemic in medicine.

其實在醫療界有一個隱藏的 「傳染病」。

Of course, patients are scared when they come to the doctor.

當然，病人就醫時總是心存恐懼。

Imagine you wake up with this terrible bellyache,

想像你因腹部劇痛而醒來，

you go to the hospital,

你去醫院看病，

you're lying in this strange place, you're on this hospital gurney,

你躺在這個奇怪的地方， 你在醫院的病床上，

you're wearing this flimsy gown,

你穿著單薄的病服，

strangers are coming to poke and prod at you.

陌生人們過來對你又戳又刺。

You don't know what's going to happen.

你不知道接下來會發生什麼事。

You don't even know if you're going to get the blanket you asked for 30 minutes ago.

你甚至不知道會不會拿到 30 分鐘前要的毛毯。

But it's not just patients who are scared;

然而害怕的不只是病人；

doctors are scared too.

醫生其實也害怕。

We're scared of patients finding out who we are

我們害怕病人發現我們的真面目，

and what medicine is all about.

並且洞悉醫療的真相。

And so what do we do?

所以我們怎麼辦呢？

We put on our white coats and we hide behind them.

我們穿上白袍，將自己藏在後面。

Of course, the more we hide,

當然，我們藏得越多，

the more people want to know what it is that we're hiding.

就越多人好奇我們究竟在隱藏什麼。

The more fear then spirals into mistrust and poor medical care.

過多的恐懼演變為 不信任和不良的醫療處置。

We don't just have a fear of sickness,

我們現在不只是害怕生病，

we have a sickness of fear.

我們也患了恐懼症。

Can we bridge this disconnect

我們能在病人所需和醫生所為之間的斷層 搭起橋樑嗎？

between what patients need and what doctors do?

Can we overcome the sickness of fear?

我們能克服恐懼症嗎？

Let me ask you differently:

讓我換個方式提問：

If hiding isn't the answer, what if we did the opposite?

如果隱藏不是正確的答案時，

假如我們反其道而行，會怎麼樣呢？

What if doctors were to become totally transparent with their patients?

如果醫生變成必須對病人完全透明， 會怎麼樣呢？

Last fall, I conducted a research study to find out

去年秋天，我做了一項實地調查，

為了了解關於醫療 大家最想知道的是什麼。

what it is that people want to know about their healthcare.

I didn't just want to study patients in a hospital,

我不想只研究醫院裡病人的想法，

but everyday people.

而是一般常人的想法。

So my two medical students, Suhavi Tucker and Laura Johns,

所以我的兩個學生── 蘇哈維．塔克和勞拉．約翰，

literally took their research to the streets.

直接到街上做調查，

They went to banks, coffee shops, senior centers,

他們去了銀行、咖啡館、老人活動中心、

Chinese restaurants and train stations.

中餐館和火車站。

What did they find?

你猜他們發現了什麼？

Well, when we asked people,

當我們問民眾：

"What do you want to know about your healthcare?"

「對於你的醫療， 你最想知道的是什麼？」

people responded with what they want to know about their doctors,

民眾回應說， 他們想了解的是他們的醫生，

because people understand health care

因為人們所了解的醫療

to be the individual interaction between them and their doctors.

是他們自己與醫生之間的個別互動。

When we asked, "What do you want to know about your doctors?"

那我們就問： 「你想知道關於你醫生的什麼呢？」

people gave three different answers.

他們給了三種不同的答案。

Some want to know that their doctor is competent

有些人想知道他們的醫生是否稱職，

and certified to practice medicine.

是否有從事醫療工作的認證。

Some want to be sure that their doctor is unbiased

有些人想確定他們的醫生是公正的，

and is making decisions based on evidence and science,

會依靠證據和科學做出決定，

not on who pays them.

而不是根據誰付錢。

Surprisingly to us,

讓我們感到驚訝的是，

many people want to know something else about their doctors.

很多人想知道醫生其他的事情。

Jonathan, a 28-year-old law student,

喬納森，28 歲的法學院學生，

says he wants to find someone who is comfortable with LGBTQ patients

表示他在找能夠接受 「非異性戀患者」，

並且專長於「非異性戀疾病」治療的醫生。

and specializes in LGBT health.

Serena, a 32-year-old accountant,

賽琳娜，32 歲的會計師，

says that it's important to her for her doctor to share her values

表示醫生認同她的價值觀 對她而言很重要，

when it comes to reproductive choice and women's rights.

尤其是涉及生育選擇和女性權利時。

Frank, a 59-year-old hardware store owner,

弗蘭克，59 歲的五金行老闆，

doesn't even like going to the doctor

甚至不喜歡去看醫生，

and wants to find someone who believes in prevention first,

他想找的是相信預防優先，

but who is comfortable with alternative treatments.

並且能接受另類療法的醫生。

One after another, our respondents told us

一個接一個的受訪者告訴我們

that that doctor-patient relationship is a deeply intimate one —

醫生和病人之間的關係 其實是非常親密的，

that to show their doctors their bodies

在讓他們的醫生看到自己的身體

and tell them their deepest secrets,

並告訴他們自己最深層的秘密之前，

they want to first understand their doctor's values.

他們想先了解醫生的價值準則。

Just because doctors have to see every patient

僅僅因為醫生需要看他們所有的病人，

doesn't mean that patients have to see every doctor.

並不意味著病人需要去看所有的醫生。

People want to know about their doctors first

人們想先了解醫生，

so that they can make an informed choice.

他們才可以做出有根據的選擇。

As a result of this, I formed a campaign,

根據這個調查結果，我發起了一個活動，

Who's My Doctor?

「我的醫生是誰？」

that calls for total transparency in medicine.

呼籲醫學界完全透明化。

Participating doctors voluntarily disclose

參與的醫生

自願在一個公共網站上公開，

on a public website

not just information about where we went to medical school

不僅是關於我們讀哪所醫學院

and what specialty we're in,

和我們的醫療專長，

but also our conflicts of interest.

並且公開我們的利益衝突。

We go beyond the Government in the Sunshine Act

我們超越政府在陽光法案中

about drug company affiliations,

醫生和藥廠的關係要公開的規定，

and we talk about how we're paid.

我們公布自己的收入來源。

Incentives matter.

金錢誘因是很重要的。

If you go to your doctor because of back pain,

如果你因為背痛去看醫生，

you might want to know he's getting paid 5,000 dollars to perform spine surgery

你也許想知道

他幫你做脊椎手術會賺到五千美元，

versus 25 dollars to refer you to see a physical therapist,

而推薦你去看復健師只能賺到 25 美元，

or if he's getting paid the same thing no matter what he recommends.

或者不管他推薦哪一種，收入都一樣。

Then, we go one step further.

然後，我們再進一步。

We add our values when it comes to women's health,

我們在談到婦女健康、

LGBT health, alternative medicine,

非異性戀者的健康、另類醫療、

preventive health, and end-of-life decisions.

預防保健和臨終決定時 會提出自己的價值觀。

We pledge to our patients that we are here to serve you,

我們對病人宣誓要服務你們，

so you have a right to know who we are.

所以你們有權了解我們。

We believe that transparency can be the cure for fear.

我們相信這種透明可以治療恐懼症。

I thought some doctors would sign on and others wouldn't,

我原以為有些醫生會加入我們，有些不會，

but I had no idea of the huge backlash that would ensue.

但我從沒想到會因此引起強烈反彈。

Within one week of starting Who's My Doctor?

在「我的醫生是誰」發起的一周內，

Medscape's public forum

醫景 (Medscape) 公共論壇

and several online doctors' communities

和一些醫生社團網站

had thousands of posts about this topic.

出現上千則關於這個話題的貼文。

這裡有一些例子。

Here are a few.

波特蘭的腸胃科醫生說：

From a gastroenterologist in Portland:

"I devoted 12 years of my life to being a slave.

「我奉獻了 12 年的生命做奴隸。

I have loans and mortgages.

我有一些貸款和房貸。

I depend on lunches from drug companies to serve patients."

我得靠製藥公司提供午餐 才能服務患者。」

Well, times may be hard for everyone,

生活在這個時代每個人都很困難，

but try telling your patient

但是你可以試試告訴那些

making 35,000 dollars a year to serve a family of four

每年賺三萬五千美元養活一家四口的病人

that you need the free lunch.

你需要免費的午餐。

From an orthopedic surgeon in Charlotte:

來自夏洛特的一名整形外科醫生說：

"I find it an invasion of my privacy to disclose where my income comes from.

「我認為公開收入來源 是侵犯我的隱私。」

My patients don't disclose their incomes to me."

「我的病人也不向我公開他們的收入。」

But your patients' sources of income don't affect your health.

但是病人的收入來源不影響你的健康。

From a psychiatrist in New York City:

來自紐約市的一名精神科醫生寫道：

"Pretty soon we will have to disclose whether we prefer cats to dogs,

「不久後我們就必須公開 我們喜歡貓還是狗、

what model of car we drive,

開哪種車、

and what toilet paper we use."

用哪種衛生紙。」

Well, how you feel about Toyotas or Cottonelle

你對豐田汽車或者綿柔衛生紙的看法

won't affect your patients' health,

不會影響病人的健康，

but your views on a woman's right to choose

但是你對於婦女選擇權、預防醫學

and preventive medicine and end-of-life decisions just might.

和臨終決定的觀點，就可能會影響。

And my favorite, from a Kansas City cardiologist:

我最喜歡的一則是 來自堪薩斯市的心臟科醫生說：

"More government-mandated stuff?

「更多政府強制管理的鳥事？

Dr. Wen needs to move back to her own country."

溫醫生可以回自己的國家去​​了。」

Well, two pieces of good news.

好的，我有兩個好消息。

First of all, this is meant to be voluntary and not mandatory,

首先，這是自願而不是強制的，

and second of all, I'm American and I'm already here.

其次，我是美國人，我已經在這裡了。

(Laughter) (Applause)

（笑聲）（掌聲）

Within a month, my employers were getting calls

在一個月之內，我的僱主接到很多來電

asking for me to be fired.

要求解僱我。

I received mail at my undisclosed home address

我在從未公開的住家地址收到

with threats to contact the medical board to sanction me.

威脅要聯繫醫務委員制裁我的郵件。

My friends and family urged me to quit this campaign.

我的朋友和家人力勸我放棄這個活動。

After the bomb threat, I was done.

在收到炸彈威脅後，我停止了活動。

But then I heard from patients.

後來我卻收到來自病人的訊息。

Over social media, a TweetChat,

在社交媒體推特聊天室上，

which I'd learned what that was by then,

當時我才知道那個網站，

generated 4.3 million impressions,

這件事出現在 430 萬人次的版上，

and thousands of people wrote to encourage me to continue.

有數千人留言鼓勵我堅持下去。

They wrote with things like,

他們留言說：

"If doctors are doing something they're that ashamed of,

「如果醫生在做他們自己都 感到羞恥的事情，

they shouldn't be doing it."

他們就不該繼續做。」

"Elected officials have to disclose campaign contributions.

「民選官員必須公開選舉經費明細。

Lawyers have to disclose conflicts of interests.

律師必須要公開是否有利益衝突，

Why shouldn't doctors?"

為什麼醫生就不行？」

And finally, many people wrote and said,

最後，還有很多人留言：

"Let us patients decide

「讓我們這些病人來決定

what's important when we're choosing a doctor."

選醫生要看什麼才重要。」

In our initial trial,

我們初次嘗試的時候，

over 300 doctors have taken the total transparency pledge.

超過三百位醫生參與了這項 完全透明的承諾。

What a crazy new idea, right?

很瘋狂的想法，對吧？

But actually, this is not that new of a concept at all.

其實這個概念根本沒那麼新。

Remember Dr. Sam, my doctor in China,

記得山姆醫生嗎？我在中國的醫生，

with the goofy jokes and the wild hair?

會說些傻笑話、頭髮很亂的那位。

Well, she was my doctor,

她是我的醫生，

but she was also our neighbor

也是我們的鄰居，

who lived in the building across the street.

就住在對面。

I went to the same school as her daughter.

我和她的女兒上同一所學校。

My parents and I trusted her

我和爸媽都很信任她，

because we knew who she was and what she stood for,

因為我們都知道她是誰， 還有她的價值觀點，

and she had no need to hide from us.

她也沒必要向我們隱瞞。

Just one generation ago, this was the norm in the U.S. as well.

這在上一代的美國也很常見。

You knew that your family doctor was the father of two teenage boys,

你知道你的家庭醫生 有兩個十幾歲的兒子，

that he quit smoking a few years ago,

他在幾年前戒了煙，

that he says he's a regular churchgoer,

他說他常上教堂做禮拜，

but you see him twice a year: once at Easter

但是你一年才會見到他兩次， 一次在復活節，

and once when his mother-in-law comes to town.

一次在他的岳母來探望他時。

You knew what he was about,

你知道他的事情，

and he had no need to hide from you.

他也沒必要向你隱瞞。

But the sickness of fear has taken over,

但是恐懼症席捲了這一切，

and patients suffer the consequences.

而病人承擔後果。

I know this firsthand.

我也親自體會過。

My mother fought her cancer for eight years.

我媽媽和癌症抗爭了八年。

She was a planner,

她是善於計劃的人，

and she thought a lot about how she wanted to live

她思考了她要如何活

and how she wanted to die.

以及她要如何死。

Not only did she sign advance directives,

她不僅簽了臨終醫療指示，

she wrote a 12-page document about how she had suffered enough,

還寫了一份 12 頁的文章敘述 她已經受夠了痛苦，

how it was time for her to go.

是她該離開的時候了。

One day, when I was a resident physician,

我還是住院醫師的某一天，

I got a call to say that she was in the intensive care unit.

接到電話說她在加護病房。

By the time I got there, she was about to be intubated

我趕過去的時候，她就快被插管，

and put on a breathing machine.

而且要接上呼吸機了。

"But this is not what she wants," I said, "and we have documents."

我說：「這不是她要的治療。

我們有她簽的指示文件。」

The ICU doctor looked at me in the eye,

加護病房的醫生看著我的眼睛，

pointed at my then 16-year-old sister, and said,

指著我 16 歲的妹妹，然後說：

「你還記得在你妹妹那般年紀時，

"Do you remember when you were that age?

How would you have liked to grow up without your mother?"

你會要過沒有媽媽的日子嗎？」

Her oncologist was there too, and said,

她的腫瘤科醫師也在那裡，說道：

"This is your mother.

「這可是你的母親，

Can you really face yourself for the rest of your life

如果你不為她做出任何行動的話，

if you don't do everything for her?"

你真的能在未來的日子裡 坦然面對自己嗎？」

I knew my mother so well.

我太了解我母親了。

I understood what her directives meant so well,

我很清楚理解她的指示，

but I was a physician.

但我是一個醫生。

That was the single hardest decision I ever made,

我此生做過最艱難的決定

就是讓她平靜的過世。

to let her die in peace,

and I carry those words of those doctors with me

我每天都記得

every single day.

那些醫生對我說的話。

我們可以在病人所需

We can bridge the disconnect

between what doctors do and what patients need.

和醫生所為之間的斷層搭起橋樑。

我們能做到，因為我們做過，

We can get there, because we've been there before,

and we know that transparency gets us to that trust.

而且我們知道公開透明必將得到信任。

Research has shown us that openness also helps doctors,

研究告訴我們公開也會幫助醫生，

that having open medical records,

藉由公開醫療紀錄，

being willing to talk about medical errors,

願意討論醫療過失，

will increase patient trust,

就能提升病人對我們的信任感，

improve health outcomes,

改善治療結果，

and reduce malpractice.

進而減少醫療疏失。

That openness, that trust,

那份透明，那份信任，

is only going to be more important

在從關注疾病的傳染 轉為關注疾病的行為模式時，

as we move from the infectious to the behavioral model of disease.

會更加為重要。

Bacteria may not care so much about trust and intimacy,

細菌並不關心信任和人際關係，

but for people to tackle the hard lifestyle choices,

但是人們面對選擇 攸關性命的生活模式時，

to address issues like smoking cessation,

像是在戒煙、

blood-pressure management and diabetes control,

血壓控制和糖尿病控制，

well, that requires us to establish trust.

就需要建立彼此的信任。

Here's what other transparent doctors have said.

這裡是其他支持醫療透明化的醫生所說的。

Brandon Combs, an internist in Denver:

布蘭德．柯布，來自丹佛的內科醫生說：

"This has brought me closer to my patients.

「這（透明化）縮短了 我和病人之間的距離，

The type of relationship I've developed —

我建立的醫病關係，

that's why I entered medicine."

是我從事醫療工作的原因。」

Aaron Stupple, an internist in Denver:

艾倫．斯泰普，來自丹佛的內科醫生：

"I tell my patients that I am totally open with them.

「我告訴我的病人，我對他們完全公開。

I don't hide anything from them.

我不向他們隱瞞任何事情。

This is me. Now tell me about you.

這就是我，告訴我你的故事，

We're in this together."

我們一起解決你的問題。」

May Nguyen, a family physician in Houston:

阮梅，休斯頓的家庭醫師說：

"My colleagues are astounded by what I'm doing.

「我的同事對我做的事感到震驚，

They ask me how I could be so brave.

他們問我為什麼能如此勇敢。」

I said, I'm not being brave,

我回答：「 這不是勇敢，

it's my job."

我只是在做我的工作而已。」

在此，我留下最後一點讓大家思考。

I leave you today with a final thought.

Being totally transparent is scary.

完全透明是一件十分恐怖的事情。

You feel naked, exposed and vulnerable,

你有一種全身赤裸、

毫無遮掩、脆弱的感覺，

but that vulnerability, that humility,

然而那份脆弱感，那份謙遜，

it can be an extraordinary benefit to the practice of medicine.

對行醫會有極大的好處。

When doctors are willing to step off our pedestals,

當醫生願意放下架子，

take off our white coats,

脫下白袍，

and show our patients who we are and what medicine is all about,

並且向病人展示我們是怎樣的人，

以及醫療是怎樣運作的時候，

that's when we begin to overcome the sickness of fear.

這才是我們開始克服恐懼症的開始。

That's when we establish trust.

那才是我們建立信任的時候，

That's when we change the paradigm of medicine

那才是我們改變醫療模式的時候，

from one of secrecy and hiding

對我們的病人

to one that is fully open and engaged

從隱藏躲閃，

到完全公開、全心全意的投入。

for our patients.

Thank you.

謝謝。

(Applause)

（掌聲）